From Open Heads to Open Minds

Steeped in a serious mental health crisis about 15 years back, I asked my doctor what would have become of me if I’d lived a few centuries ago. He said that I’d likely have been diagnosed as an “hysterical” woman and institutionalized and/or treated with “Who knows what!”

As I healed from that anxiety and depression with the help of the medical community and my circle of family and friends, I became increasingly grateful that, living nowadays, I have access to information, treatment, and therapy that restored my sense of self steadily over time and brought meaning and productivity back to my life.

But I still wonder, what would it have been like 100 or more years ago? Let’s start by looking at mental health and mental illness by today’s standards.

The World Health Organization defines ‘mental health’ as, “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.”

Mental illness, on the other hand, is referred to by the Mayo Clinic as “a wide range of mental health conditions — disorders that affect your mood, thinking, and behavior.” Most of us have mental health concerns from time to time (e.g., the grief felt when a loved one dies), but a concern can become a mental illness when ongoing signs and symptoms cause frequent stress and affect our ability to function.

There are nearly 300 mental disorders listed in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), which is used by health professionals to help diagnose mental illness. These include mood disorders such as depression or bipolar, anxiety disorders, psychotic disorders such as schizophrenia, trauma-induced disorders, personality disorders, eating disorders, and substance abuse disorders.

Looking way back…

As reported recently in MedScape, “Before modern psychotherapy, before Prozac®, before deep brain stimulation, there were cranial drills, hot showers, and tooth extractions. The annals of psychiatric medicine trace all the way back to the ancient Greeks and Egyptians and contain—perhaps more so than in any other field of medicine—an array of unusual treatments that today would send ripples throughout even the most tolerant medical licensing board.”

Take trepanation, for example. Beginning about 7,000 years ago, healers of the day opened a person’s skull with a bore, auger, or even a saw to enable the exit of mental illness or evil spirits.

The ancient Romans and Egyptians considered mental illness to be religious in nature. They thought people with mental disorders could be possessed by demons and, therefore, used exorcism as a form of treatment.

Early Greek healers used bleeding, purging, and even vomiting to help correct physical and mental imbalances they thought caused mental illness. In the 5th century BC, however, Greek physician Hippocrates shared his beliefs that mental illness was physiologically affiliated. As a result, his treatment methods included changes in environment, living conditions, or occupations.

Despite Hippocrates’ enlightened observations and practices, mental illness was still misunderstood and mistreated centuries later. Townspeople feared it, poets and playwrights wrote about it, and those afflicted were locked up in prisons, forced to endure inhumane conditions.

According to MedScape, however, Hippocrates' not-so-progressive theory on mental illness in women “inspired many centuries of medical misogyny. The ancient Greek healer attributed female psychiatric symptoms to ‘hysteria,’ or the wandering of the womb throughout the body. One ‘cure’ involved exposure to foul-smelling substances intended to repel the uterus from the upper regions of the body. Plato proposed that patients simply get married and become pregnant, because gestation, he believed, ensured proper uterine positioning.”

From asylums to antidepressants…

In the 17th century, the first mental health facility was opened in Spain. The 18th century brought advocacy and “moral therapy,” where patients were unshackled and prevented from being used for public entertainment.

“The early 19th century saw a brief, confounding fad for using centrifugal force to treat mental illness,” reports MedScape. Rotational therapy, as it was known, “is credited to Erasmus Darwin, grandfather of Charles, who proposed that excessive spinning would lessen "brain congestion" by increasing pressure.”

With the early years of the 20th century came surgical incisions and extractions of teeth and organs, based on the belief that mental illness was caused by infections whose toxins were poisoning the brain. Also during that time, many psychiatrists thought that extremely hot or cold showers, water wraps, and baths could treat insomnia, suicidal ideation, aggression, and manic depression. And experiments were conducted using malaria therapy, insulin shock therapy, and chemically induced seizure therapy.

Introduced in Italy in the 1930s, electroconvulsive therapy (ECT) involved passing currents through the brain to trigger a brief seizure that changed brain chemistry. Much of the treatment’s stigma is based on these early treatments, when high doses of electricity were administered without anesthesia, causing memory loss, fractured bones, and other serious side effects.

While home care was common then, many mentally ill people were housed in what were called asylums or mental hospitals or institutions. During the ‘30s and ‘40s, society’s view of mental illness and these “madhouses” shifted, resulting in a wave of deinstitutionalization where patients were moved to outpatient or less restrictive residential settings. This movement also sparked the development of antipsychotic drugs, which were intended to make life outside institutions more manageable.

Walking the “talk”…

A few decades later, the term “psycho-therapeia” was introduced and talk therapy was a new area of study. At the turn of the 20th century, Sigmund Freud developed psychoanalysis based on his belief that mental illness was the result of keeping thoughts or memories in the unconscious mind, and that treatment, primarily listening and interpreting, would bring these memories to the forefront, thereby decreasing symptoms.

Behavioral psychology then borrowed principles from animal psychology to treat emotional and behavioral challenges. Over the years, it has been enhanced to include emphasis on a person’s thoughts and feelings. This combined cognitive behaviour therapy model has become a major treatment for many psychiatric conditions, sometimes along with medications intended for specific mental disorders.

New kid on the treatment block…

It was long thought that our brains are hardwired at birth and, therefore, unchangeable. But science has proven that our brains change continuously throughout our lives. This ‘neuroplasticity’ enables your brain to reorganize itself both physically and functionally in response to your environment, behavior, thinking, and emotions. The good news is that you can improve your mental health if you choose your experiences and actions with care.

These scientific advances, and the therapies that reflect them, are expected to take the treatment of brain damage and mental health challenges to a whole new level!

In closing…

When all’s said and done, I’m grateful I wasn’t trying to navigate my path to mental wellness in days gone by. Amongst the myriad combinations of lifestyle choices, medications, and therapies, I’ve found a regime that works for me. And who knows, maybe one day my mental health challenges will be erased from my brain via neurotechnology. HEADS UP on that!

Joanne de Vries is a communications professional who provides public education and consultation services to businesses, non-profits, and different levels of government. She is one of the principals of Alliance Communications, and the Founder and CEO of the Fresh Outlook Foundation.